两种角膜内皮显微镜测量近视屈光手术前后角膜内皮细胞密度的比较  

Comparison of corneal endothelial cell density with two non-contact specular microscopes before and after refractive surgery for the correction of myopia

作　　者：张波[1] 庞辰久[1] 任胜卫 顾宇伟 Zhang Bo;Pang Chenjiu;Ren Shengwei;Gu Yuwei(Department of Ophthalmology,Henan Provincial People＇s Hospital,Henan Provincial Eye Hospital,Zhengzhou 450003,Chin)

机构地区：[1]河南省人民医院眼科河南省立眼科医院,郑州450003

出　　处：《中华眼外伤职业眼病杂志》2018年第7期481-484,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省基础与前沿技术研究计划项目（162300410235）;河南省自然科学基金（182300410362）

摘　　要：目的比较两种非接触角膜内皮显微镜测量近视屈光手术前后角膜内皮细胞密度。方法近视91例（182只眼），用SP-1P及EM-3000两种角膜内皮显微镜检查，行SMILE术34例（67只眼），术后1周完成检查，余未手术。比较两种仪器测量术前和术后中央角膜内皮细胞密度结果，用Bland-Altman法比较两种仪器测量结果的一致性。结果近视91例（182只眼）术前两种仪器测量中央角膜内皮细胞密度组内相关系数分别为0.976、0.961，变异系数分别为0.086、0.068，角膜内皮细胞密度95%可信区间为148.27～209.87个/mm2；34例（67只眼）SMILE术后1周，两种仪器测量结果组内相关系数分别为0.973、0.879，变异系数分别为0.076、0.090, 95%可信区间为225.86～316.84个/mm2。术前、术后两种仪器测量中央角膜内皮细胞密度差异均有统计学意义（P〈0.05）。结论SP-1P及EM-3000两种角膜内皮显微镜测量近视SMILE术前结果一致性好，术后早期测量结果间一致性不佳。ObjectiveTo compare corneal endothelial cell density with two non-contact specular microscopes before and after refractive surgery for myopia.MethodsThe data of 182 eyes of 91 cases with myopia were selected. All cases were examined with SP-1P and EM-3000 non-contact corneal endothelial microscopes respectively. Among them, 67 eyes of 34 cases with myopia underwent SMILE. The corneal endothelial cell density were measured with two corneal endothelial microscopes 1 week postoperatively. The speculation microscopes measurements was compared with Bland-Altman graphs between the two methods.ResultsBefore surgery, the intraclass correlation coefficients （ICCs） of the mean corneal endothelial cell density were 0.976, 0.961 and the coefficient of variation （CVs） were 0.086, 0.068 for SP-1P and EM-3000 respectively. The 95%confidence intervals of central endothelial cell density were 148.27-209.87 cells/mm2 between SP-1P and EM-3000. One week after SMILE, the ICCs of the mean corneal endothelial cell density were 0.973, 0.879 and the CVs were 0.076, 0.090 for SP-1P and EM-3000 respectively. The 95%confidence intervals of the central endothelial cell density were 225.86-316.84 cells/mm2 between two specular microscopes. The difference of corneal endothelial cell density before and after surgery was statistically significant between the two specular microscopes （P〈0.05）.ConclusionThe measurement of central corneal endothelial cell density before SMILE with SP-1P and EM-3000 are consistent. And the measurements early postoperatively are different.

关 键 词：近视 角膜内皮显微镜 非接触式 密度 内皮细胞 角膜 飞秒激光小切口角膜基质透镜取出术 

分 类 号：R779.6[医药卫生—眼科]